The safety and well-being of all the participants is my highest priority, and as part of my commitment to ensuring a secure environment, I require the completion of this Liability Waiver Form.
A breathing session may not be suitable for you if you have the following conditions and your session may have to be modified if you have/are:
- Cardiovascular problems
- Abnormally high blood pressure
- Aneurysms
- Epilepsy and seizures in the past
- Taking heavy medication
- Severe psychiatric symptoms especially psychosis or paranoia, bipolar
- Osteoporosis
- Recent surgery
- Glaucoma
- Currently pregnant
- Experienced anaphalaxis
- People with asthma should bring their own inhalers and consult with their physician and breathing session instructor before participating.
- Experiencing an emotional or spiritual crisis or any person with a mental illness who is not in treatment or lacks adequate support.
*Please note, this list is not exhaustive, and generally advise that if you have a question about a condition, you may have that is not listed here, you consult a physician before participating in these breathing sessions. If you have any of the conditions above, please contact me on whatapp (+973 3200 3248) BEFORE you sign up for a journey to verify you have been cleared to participate.
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I warrant and represent that I am in good health physically, mentally, psychologically, and emotionally, and I understand and warrant that if I am not in good health, I will not be allowed to perform the activities and sessions.
Accordingly, the declaration and certification that I am in good health in all the above-mentioned respects constitute a material agreement to allow me to participate in the breathing sessions.
I know and acknowledge that the person facilitating is not a doctor or psychiatrist, or a specialist in health care and that the activities offered are not intended to treat and diagnose specific medical conditions, whether physical, psychological, or emotional.
I confirm I will not come to the session under the influence of any substance. I understand that by doing so will result in me being asked to leave and reschedule. No refund will be given.
I voluntarily participate in these activities knowing the risks and consequences and agree to assume all consequences, known or not.
I release my 9D Breathwork Facilitator, Susie Bower and her team, from all responsibilities, costs, and damages that may arise from participating in the above-mentioned activity. I agree to accept financial responsibility for costs related to treatment.
By adding my name and date below, I acknowledge that I have read the above warning and agree to proceed with full responsibility and understand that I have waived certain rights by signing this release of liability freely and voluntarily without any external influence. I agree that submitting my name and date on this form count as an official eSignature.